What are the key clinical signs and symptoms to recognize compartment syndrome in a patient presenting with limb pain?

Key clinical signs and symptoms to recognize compartment syndrome in a patient presenting with limb pain include:

• Severe pain disproportionate to the injury that is persistent and worsens despite analgesia, often described as deep and burning in nature ¹ (Frink et al., 2010).
• Pain on passive stretch of the muscles within the affected compartment, which is an early and sensitive clinical indicator ¹ (Frink et al., 2010).
• Tense, swollen compartment on palpation, indicating increased intracompartmental pressure ¹ (Frink et al., 2010).
• Paresthesia or sensory deficits in the distribution of nerves passing through the compartment, reflecting early nerve ischemia ¹ (Frink et al., 2010).
• Muscle weakness or paralysis may develop as the syndrome progresses, indicating muscle and nerve compromise ¹ (Frink et al., 2010).
• Pallor and pulselessness are late signs and may indicate vascular compromise; however, pulses can be present early in compartment syndrome and their absence is not required for diagnosis ¹ (Frink et al., 2010).

Early recognition relies heavily on clinical assessment focusing on pain characteristics and neurological symptoms, as compartment pressure measurement is not always immediately available or definitive ¹ (Frink et al., 2010). Prompt diagnosis and surgical intervention are critical to prevent permanent tissue damage.